MEDICARE: JOEL M FIEDLER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	MD031017E	PA
2	208000000X	Pediatrics Physician	25MA04602400	NJ
3	2080P0201X	Pediatric Allergy/Immunology Physician	MD031017E	PA
4	2080P0201X	Pediatric Allergy/Immunology Physician	25MA04602400	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346259363
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOEL M FIEDLER M.D.

Provider Business Mailing Address
First Line	:	100 E PENN SQ
Second Line	:	9TH FLOOR
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-3323
Country	:	US
Telephone Number	:	267-425-9234
Fax Number	:	267-425-9299

Provider Business Practice Location Address
First Line	:	1012 LAUREL OAK RD
Second Line	:	CHOP CARE NETWORK AT VOORHEES SPECIALTY CARE
City	:	VOORHEES
State	:	NJ
Zip	:	08043-3505
Country	:	US
Telephone Number	:	856-435-0086
Fax Number	:	856-435-0091

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2006
Last Update Date	:	12/03/2018

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